{"id":178,"date":"2009-05-31T08:34:07","date_gmt":"2009-05-31T14:34:07","guid":{"rendered":"http:\/\/cchrstl.org\/wordpress\/?p=178"},"modified":"2024-07-14T05:43:47","modified_gmt":"2024-07-14T10:43:47","slug":"foster-children-in-florida-on-powerful-psychiatric-drugs","status":"publish","type":"post","link":"https:\/\/www.cchrstl.org\/wordpress\/2009\/05\/31\/foster-children-in-florida-on-powerful-psychiatric-drugs\/","title":{"rendered":"Foster children in Florida on powerful psychiatric drugs"},"content":{"rendered":"

St. Petersburg Times
\nFlorida Department of Children and Families review finds shortfalls in monitoring of foster children on psychiatric drugs<\/strong><\/span>
\nBy Kris Hundley, Times Staff Writer
\nIn Print: <\/span>May 29<\/span>, 2008<\/p>\n

Spurred by the shocking suicide of a 7-year-old on psychiatric drugs, the agency in charge of Florida’s foster children has discovered serious shortcomings in its monitoring of kids on such powerful prescriptions.<\/span><\/p>\n

After reviewing its files, the Department of Children and Families determined it had under-counted the number of foster kids on such medications as Risperdal and Adderall, overlooking hundreds of cases.<\/p>\n

It also has failed to meet its legal requirement that such prescriptions be given only after parental consent or court order.<\/p>\n

On Thursday, DCF said a review of the files of more than 20,000 children currently in the state’s foster care showed 2,669, or 13.19 percent, are taking one or more psychotropic medications.<\/p>\n

That compares to about 4 or 5 percent of children in the general population who are on such prescriptions.<\/p>\n

Of those foster children taking drugs, DCF discovered 16 percent had no proof either a parent or judge had signed off on the prescription, as required by a 2005 Florida law.<\/p>\n

“That is unacceptable,” said DCF’s secretary George Sheldon. “We’re going to bring every single case of a foster child on drugs into compliance with the law.”<\/p>\n

Concerns about pediatric use of anti-psychotic and anti-depressants have been growing along with increased warnings of such side effects as suicide, diabetes and weight gain. Few of the drugs have been tested or approved by the FDA for children, though physicians can prescribe them for this age group.<\/p>\n

Robin Rosenberg, a Tampa lawyer and deputy director of Florida’s Children First, said advocacy groups like hers have been fighting for oversight of psychotropic drugs for years. “We’re not as far along as we should have been if the state had followed up on serious concerns starting in the late 1990s,” she said. “It’s a shame we’re in this place today.”<\/p>\n

Sheldon, who was named to the top job at DCF in October, left no doubt that he had been deeply affected by Gabriel Myers, the 7-year-old who hanged himself on a shower hose in south Florida in mid-April. The boy was in his third foster home and on Vyvanse, a medication for ADHD, as well as Symbyax, a combination of anti-psychotic and anti-depressant.<\/p>\n

Though his caseworker repeatedly said Gabriel’s mother had agreed to the medications, that was not true. The boy’s psychotropic medications also had not been entered in the state’s tracking system.<\/p>\n

To correct ongoing problems, Sheldon set a deadline of June 5 for action on cases without consent. This could include scheduling new doctors’ appointments, gaining informed consent from parents or expediting a judge’s review of the prescription.<\/p>\n

Sheldon said he also was going to focus on the cases of 73 children under age 6 found to be on psychotropic drugs.<\/p>\n

“I want a sense of urgency, but I also want to get it right,” he said. “I want to move forward, but I think it’s important for the agency to apologize for misinformation it may have put out in the past.”<\/p>\n

Flaws in DCF’s record-keeping became clear in the immediate aftermath of Gabriel’s death. An initial review of the state’s database showed only 1,950 kids on psychotropic prescriptions. After a thorough review of individual records, however, that number grew by more than 700.<\/p>\n

Preliminary data released in mid-May also showed some questionable dates on judicial consent. Though it’s not inconceivable a judge might sign an order on a Saturday or Sunday, early returns showed weekend consent orders on 129 occasions.<\/p>\n

The final database, including information on types of drugs and diagnoses, was not available Thursday. Sheldon said a summary of the drug data would be posted on the DCF Web site and updated weekly.<\/p>\n

“I’ve got a lot more confidence in these numbers than I had two weeks ago,” he said. “But any database is only as good as the quality of the information being put into it.”<\/p>\n

One ongoing area of concern, Sheldon said, is the validity of any consent given by parents whose kids are in the state’s custody.<\/p>\n

“A parent whose child is taken into our care is going to sign virtually anything and that’s not informed consent,” he said. “My preference is that the biological parent have a dialog with the psychiatrist.”<\/p>\n

Now that DCF has a handle on the number of foster children on psychotropic drugs, Sheldon said the department can begin to address the bigger issue of the efficacy of such drugs.<\/p>\n

He has asked an independent panel investigating Gabriel Myers’ death to make recommendations on improving DCF’s oversight of these medications. Sheldon said a second-party review of all such prescriptions might be necessary; currently, only prescriptions for kids under age 6 require such review.<\/p>\n

DCF has set up a page on its web site <\/a>that tracks the progress of the panel investigation into the boy’s suicide. The page includes a photo of the smiling boy.<\/p>\n

“We have his face on the screen watching us to see how well we learned from his life and death,” Sheldon said. “We cannot let him down.” <\/span><\/span><\/p>\n

Source:\u00c2\u00a0http:\/\/www.tampabay.com\/news\/health\/medicine\/article1005344.ece<\/span><\/a><\/span><\/span><\/p>\n

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Miami Herald
\nMore Florida foster kids than thought are given mental-health drugs
\nA state database of foster-care records badly underreported the number of foster children on powerful psychiatric drugs, child-welfare bosses revealed.<\/span><\/strong><\/span>
\nIn Print: <\/span>May 29, 2008
\nBy CAROL MARBIN MILLER<\/p>\n

Nearly three of 10 teenage Florida foster children have been prescribed a mental-health drug, and 73 foster kids younger than 6 are taking mind-altering drugs, according to a study <\/a>released Thursday in response to the death of a Broward foster child who was taking such medications.<\/p>\n

In all, 2,669 children — or 13 percent of Florida foster children — are being given powerful psychiatric drugs, said the study, commissioned last month by Department of Children & Families Secretary George Sheldon. The largest group, almost 60 percent, are teens ages 13 to 17.<\/p>\n

The 2,669 children represent about one-third more kids than a DCF database had reported as taking mental-health drugs — meaning electronic state records had significantly underestimated the use of mind-altering drugs.<\/p>\n

Child-welfare administrators are investigating the use of mental-health drugs by children in state care in the wake of the April 16 death of Gabriel Myers, a troubled 7-year-old boy who hanged himself in the shower of his Margate foster home.<\/p>\n

The Miami Herald reported that Gabriel had been given psychiatric drugs in his final weeks, including anti-depressants that are linked to a higher risk of suicide among children. Contrary to a 4-year-old law adopted after Herald stories, neither Gabriel’s parents nor a judge had consented to the use of such drugs.<\/p>\n

”Normally, a 7-year-old boy is learning how to read and tie his shoes,” Sheldon said. “It is incomprehensible to me even now that a child so young may have deliberately and consciously made a decision to end his life.”<\/p>\n

Sheldon, a former deputy attorney general, said he had ”serious questions” about the use of mental-health drugs on children. Many such drugs have never been approved by the Food and Drug Administration for use on children, and many are linked to serious side effects.<\/p>\n

`CHEMICAL RESTRAINTS’<\/p>\n

”I think this should be done as a last resort, after a full review by . . . medical professionals,” Sheldon said.<\/p>\n

For almost a decade, Florida child advocates have complained that mental-health drugs are being used as ”chemical restraints” to control some foster kids.<\/p>\n

On Thursday, Andrea Moore — a former head of Florida’s Children First who first suggested child-welfare workers were relying on mental-health drugs to control behavior — said the large number of older foster children and children in institutional settings makes such concerns far more pressing.<\/p>\n

”The shift-care workers at group homes are much more likely to report sadness and crying as depression, or anxiousness as some sort of mental-health problem,” Moore said. “You’d be sad and anxious, too, if you didn’t know where you were going to live from day to day.”<\/p>\n

Moore also expressed concerns that the data may not be trustworthy. Sheldon acknowledged Thursday that the numbers had not been compared with a database kept by the state’s Medicaid program. The agency also has acknowledged that caregivers were once told they did not need consents for mental-health drugs in certain cases — meaning the drugs may not be listed at all.<\/p>\n

Among the 20,235 children whose case files were studied, investigators found no parental or judicial consent on record for 16 percent of the children, the report said.<\/p>\n

Like previous studies, the new report shows that children in foster homes, group homes or other institutional settings are far more likely to be given mental-health drugs than children living with relatives. Overall, only 4 percent of children in relative care have been prescribed psychiatric drugs, compared with 21 percent for foster homes and 26 percent for other out-of-home settings.<\/p>\n

COMPARISON<\/p>\n

The disparity is particularly acute among older children: Among children 13 to 17, nearly 12 percent of those living with relatives have been prescribed at least one mental-health drug, compared with 35 percent in foster care and 33 percent in other institutional settings, the report says.<\/p>\n

The private foster-care agencies in Miami-Dade and Broward fared about average in caring for the adolescents. Thirty percent of teens in the care of Our Kids in Miami-Dade had been given one or more mental-health drug, compared with 28 percent of Broward foster kids.<\/p>\n

In contrast to the children in state care, about 4 to 5 percent of children in the general population are taking one or more mental-health drug, said Dr. Rajiv Tandon, a former DCF chief psychiatrist who belongs to a work group Sheldon appointed to study Gabriel’s death.<\/p>\n

The report outlines steps DCF administrators will take, including:<\/p>\n

\u00e2\u20ac\u00a2 State child-welfare lawyers will seek consent from parents who still have authority to make decisions on their children’s behalf, or go to court to seek approval for mental-health drugs.<\/p>\n

\u00e2\u20ac\u00a2 Administrators are launching an ”immediate” review to determine how reliable the state’s child-welfare database is.<\/p>\n

`IMPORTANT FIRST STEP’<\/p>\n

\u00e2\u20ac\u00a2 DCF administrators and the heads of private foster-care agencies throughout the state will discuss the use of psychiatric drugs by foster children weekly by telephone.<\/p>\n

”The purpose of these calls is to ensure effective communication on improvements that must take place,” the report said.<\/p>\n

”This report is an important first step in closely examining not only this case — but to help ensure this type of tragedy never happens again,” Sheldon said Thursday at a news conference. <\/span><\/span><\/span><\/p>\n

Source: http:\/\/www.miamiherald.com\/460\/story\/1070905.html<\/span><\/a><\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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